2,293 research outputs found

    Clear the Air: Moving towards a more supportive, welcoming, Tobacco-free Clark University

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    The deleterious health effects of the consumption of tobacco products, especially for youth, have been documented thoroughly and are nearly universally recognized. Numerous federal, state, and local regulations, coupled with health education and tobacco cessation initiatives have been launched to address these effects. Although these pushes have done much to reduce the rates of preventable health conditions and death due to the usage of tobacco, there remains much work to be done at the local level to discourage and disrupt patterns of substance use and abuse. The mission of Clark Clear the Air is to propose various and creative ways in which Clark University can work to reduce the rates at which tobacco products are used in our community, including a tobacco-free policy on campus, while simultaneously fostering a welcoming and supportive space and a community-based approach to accountability with this policy

    Bioresorbable vascular scaffolds versus conventional drug-eluting stents across time : a meta-analysis of randomised controlled trials

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    Background: Bioresorbable vascular scaffolds (BVS) were designed to reduce the rate of late adverse events observed in conventional drug-eluting stents (DES) by dissolving once they have restored lasting patency. Objectives: Compare the safety and efficacy of BVS versus DES in patients receiving percutaneous coronary intervention for coronary artery disease across a complete range of randomised controlled trial (RCT) follow-up intervals. Methods: A systematic review and meta-analysis was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMBASE and Web of Science were searched from inception through 5 January 2022 for RCTs comparing the clinical outcomes of BVS versus DES. The primary safety outcome was stent/scaffold thrombosis (ST), and the primary efficacy outcome was target lesion failure (TLF: composite of cardiac death, target vessel myocardial infarction (TVMI) and ischaemia-driven target lesion revascularisation (ID-TLR)). Secondary outcomes were patient-oriented composite endpoint (combining all-death, all-MI and all-revascularisation), its individual components and those of TLF. Studies were appraised using Cochrane’s Risk of Bias tool and meta-analysis was performed using RevMan V.5.4. Results: 11 919 patients were randomised to receive either BVS (n=6438) or DES (n=5481) across 17 trials (differing follow-up intervals from 3 months to 5 years). BVS demonstrated increased risk of ST across all timepoints (peaking at 2 years with risk ratio (RR): 3.47; 95% CI 1.80 to 6.70; p=0.0002). Similarly, they showed increased risk of TLF (peaking at 3 years, RR: 1.35; 95% CI 1.07 to 1.70; p=0.01) resulting from high rates of TVMI and ID-TLR. Though improvements were observed after device dissolution (5-year follow-up), these were non-significant. All other outcomes were statistically equivalent. Applicability to all BVS is limited by 91% of the BVS group receiving Abbott’s Absorb. Conclusion: This meta-analysis demonstrates that current BVS are inferior to contemporary DES throughout the first 5 years at minimum

    An IRT Analysis of Motive Questionnaires: The Unified Motive Scales

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    Multiple inventories claiming to assess the same explicit motive (achievement, power, or affiliation) show only mediocre convergent validity. In three studies (N = 1685) the structure, nomological net, and content coverage of multiple existing motive scales was investigated with exploratory factor analyses. The analyses revealed four approach factors (achievement, power, affiliation, and intimacy) and a general avoidance factor with a facet structure. New scales (the Unified Motive Scales; UMS) were developed using IRT, reflecting these underlying dimensions. In comparison to existing questionnaires, the UMS have the highest measurement precision and provide short (6-item) and ultra-short (3-item) scales. In a fourth study (N = 96), the UMS demonstrated incremental validity over existing motive scales with respect to several outcome criteria

    Coping with the effects of fear of failure in young elite athletes

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    Coping with stress is an important element in effective functioning at the elite level in sports, and fear of failure (FF) is an example of a stressor that athletes experience. Three issues underpin the present preliminary study. First, the prevalence of problems attributed to FF in achievement settings. Second, sport is a popular and significant achievement domain for children and adolescents. Third, there is a lack of research on FF in sport among this population. Therefore, the objectives of the study were to examine the effects of FF on young athletes and to find out their coping responses to the effects of FF. Interviews were conducted individually with nine young elite ath­letes (5 males, 4 females; ages 14-17 years). It was inferred from the data that FF affected the athletes' well-being, interpersonal behavior, sport performance, and schoolwork. The athletes employed a combination of problem-focused, emotion-fo­cused, and avoidance-focused coping strategies, with avoidance strategies being the most frequently reported

    Non-response to a life course socioeconomic position indicator in surveillance: comparison of telephone and face-to-face modes

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    © 2008 Chittleborough et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Measurement of socioeconomic position (SEP) over the life course in population health surveillance systems is important for examining differences in health and illness between different population groups and for monitoring the impact of policies and interventions aimed at reducing health inequities and intergenerational disadvantage over time. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. This study compared recall of parents' highest level of education in telephone and face-to-face surveys. Methods Questions about father's and mother's highest education level were included in two representative population health surveys of South Australians aged 18 years and over in Spring 2004. A random sample selected from the electronic white pages (EWP) responded to a computer-assisted telephone interview (n = 2999), and a multistage clustered area sample responded to a face-to-face interview (n = 2893). A subsample of respondents in the face-to-face sample who owned a telephone that was listed in the EWP (n = 2206) was also compared to the telephone interview sample. Results The proportion of respondents who provided information about their father's and mother's highest education level was significantly higher in the face-to-face interview (86.3% and 87.8%, respectively) than in the telephone interview (80.4% and 79.9%, respectively). Recall was also significantly higher in the subsample of respondents in the face-to-face interview who had a telephone that was listed in the EWP. Those with missing data for parents' education were more likely to be socioeconomically disadvantaged regardless of the survey mode. Conclusion While face-to-face interviewing obtained higher item response rates for questions about parents' education, survey mode did not appear to influence the factors associated with having missing data on father's or mother's highest education level

    A Methodological Framework for the Evaluation of Syndromic Surveillance Systems: A Case Study of England

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    Background: Syndromic surveillance complements traditional public health surveillance by collecting and analysing health indicators in near real time. The rationale of syndromic surveillance is that it may detect health threats faster than traditional surveillance systems permitting more timely, and hence potentially more effective public health action. The effectiveness of syndromic surveillance largely relies on the methods used to detect aberrations. Very few studies have evaluated the performance of syndromic surveillance systems and consequently little is known about the types of events that such systems can and cannot detect. Methods: We introduce a framework for the evaluation of syndromic surveillance systems that can be used in any setting based upon the use of simulated scenarios. For a range of scenarios this allows the time and probability of to be determined and uncertainty is fully incorporated. In addition, we demonstrate how such a framework can model the benefits of increases in the number of centres reporting syndromic data and also determine the minimum size of outbreaks that can or cannot be detected. Here, we demonstrate its utility using simulations of national influenza outbreaks and localised outbreaks of cryptosporidiosis. Results: Influenza outbreaks are consistently detected with larger outbreaks being detected in a more timely manner. Small cryptosporidiosis outbreaks (<1000 symptomatic individuals) are unlikely to be detected. We also demonstrate the advantages of having multiple syndromic data streams (e.g. emergency attendance data, telephone helpline data, general practice consultation data) as different streams are able to detect different types outbreaks with different efficacy (e.g. emergency attendance data are useful for the detection of pandemic influenza but not for outbreaks of cryptosporidiosis). We also highlight that for any one disease, the utility of data streams may vary geographically, and that the detection ability of syndromic surveillance varies seasonally (e.g. an influenza outbreak starting in July is detected sooner than one starting later in the year). We argue that our framework constitutes a useful tool for public health emergency preparedness in multiple settings. Conclusions: The proposed framework allows the exhaustive evaluation of any syndromic surveillance system and constitutes a useful tool for emergency preparedness and response

    "A renewed sense of purpose": mothers' and fathers' experience of having a child following a recent stillbirth.

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    Most research has focused on mothers' experiences of perinatal loss itself or on the subsequent pregnancy, whereas little attention has been paid to both parents' experiences of having a child following late perinatal loss and the experience of parenting this child. The current study therefore explored mothers' and fathers' experiences of becoming a parent to a child born after a recent stillbirth, covering the period of the second pregnancy and up to two years after the birth of the next baby. In depth interviews were conducted with 7 couples (14 participants). Couples were eligible if they previously had a stillbirth (after 24 weeks of gestation) and subsequently had another child (their first live baby) who was now under the age of 2 years. Couples who had more than one child after experiencing a stillbirth and those who were not fluent in English were excluded. Qualitative analysis of the interview data was conducted using Interpretive Phenomenological Analysis. Five superordinate themes emerged from the data: Living with uncertainty; Coping with uncertainty; Relationship with the next child; The continuing grief process; Identity as a parent. Overall, fathers' experiences were similar to those of mothers', including high levels of anxiety and guilt during the subsequent pregnancy and after the child was born. Coping strategies to address these were identified. Differences between mothers and fathers regarding the grief process during the subsequent pregnancy and after their second child was born were identified. Despite difficulties with bonding during pregnancy and at the time when the baby was born, parents' perceptions of their relationship with their subsequent child were positive. Findings highlight the importance of tailoring support systems not only according to mothers' but also to fathers' needs. Parents', and particularly fathers', reported lack of opportunities for grieving as well as the high level of anxiety of both parents about their baby's wellbeing during pregnancy and after birth implies a need for structured support. Difficulties experienced in bonding with the subsequent child during pregnancy and once the child is born need to be normalised
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